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Community_Brain_Injury_Services_Referral_Form.pdf

Living Situation:  Alone  With Family  With Spouse  Other  Specify: ____________________...Name: ______________________________________...Emergency Contact: Name: __________________________...
https://www.southeasthealthline.ca/pdfs/Community_Brain_Injury_Services_Referral_Form.pdf

lgl_health_unit_smoking_resources_for_tobacco_for_general_public.pdf

assistance,...prescription...primary care...provider, and...discretion of...the client’s...caseworker....Advise client to:...Contact their FHT...to determine whether...they are participating...If...
https://www.southeasthealthline.ca/pdfs/lgl_health_unit_smoking_resources_for_tobacco_for_general_public.pdf

HPE Local Quit Smoking

A free app that helps users stop smoking and start living...a healthy life....FAMILY DOCTORS AND PHARMACISTS...You can talk to your doctor or pharmacist about quit...smoking medications, such as...
https://www.southeasthealthline.ca/pdfs/hpe_public_health_local_quit_smoking_support_guide.pdf

September 20, 2009

At present, QELC provides assistance with the drafting and execution of simple wills, powers of attorney...for property, and powers of attorney for personal care, assistance with...
https://www.southeasthealthline.ca/pdfs/Queens%20Elder%20Law%20Clinic%20Client%20Application%20Form.pdf

Brenda, Dianne, Amanda, Kathy and Irene of Volunteer & Information Quinte wish to thank your organization for the loyalty and support you show to us

Volunteer & Information Quinte provides high quality, professional assistance to...the residents and agencies of Hastings & Prince Edward Counties by continuously...offering up-to-date information...
https://www.southeasthealthline.ca/pdfs/About-VIQ-Membership.pdf

Kingston_Access_Services_Application_Form.pdf

occasionally requires assistance it is the responsibility of the applicant or a person responsible for them to...book a support person for those trips requiring assistance....If the...
https://www.southeasthealthline.ca/pdfs/Kingston_Access_Services_Application_Form.pdf

500160-Complex-Adult-Seating-Clinic-Referral-2019-08-3.pdf

Please Note: If you require assistance for providing basic needs while attending clinic, a caregiver must accompany you....Date: YYYY/MM/DD Referring Physician (please print):...Time: HH:MM...
https://www.southeasthealthline.ca/pdfs/500160-Complex-Adult-Seating-Clinic-Referral-2019-08-3.pdf

“APPLICATION TO REGISTER” For Health Services

Do you require any assistance? ...(Please include: mobility aids, hearing aids, visual difficulties,...etc) _________________________________________________________________________...How did you...
https://www.southeasthealthline.ca/pdfs/BQWCHC_application_referral_form_oral_Health_Services.pdf

rac_lbp_patient_intake_form_march_2020.pdf

I have support from people who can assist me with activities in the home, work or community? ...(check one)... Strongly Agree  Agree  Neutral  Disagree  Strongly Disagree...PATIENT INTAKE...
https://www.southeasthealthline.ca/pdfs/rac_lbp_patient_intake_form_march_2020.pdf

CPC Patient Information Sheet

BussieDh...Ministry of Health ...Ontario Community Physiotherapy Clinic...Program: Patient Information...Questions? ...Please visit:...www.ontario.ca/physiotherapy...Ontario’s Community Physiotherapy...
https://www.southeasthealthline.ca/pdfs/Napanee%20Physiotherapy%20and%20Rehabilitation%20-%20OHIP%20Insured%20Physiotherapy%20Information.pdf